| NPI | 1326047291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 197100) |
| Additional Taxonomies | 208VP0000X (Licence: NY 197100) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 197100) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 197100) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 197100) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2013-03-26 |